A letter I’m sending to my psychiatrist

I am writing to inform you that I wish to be discharged from your care. I will not be attending my planned appointment on 13th July.

After our last meeting I was very upset. I felt that you didn’t listen to me and didn’t give me the opportunity to explain what was going on for me. I found the way you spoke to me very confrontational and this caused me distress. I felt that you were not willing to try to understand what it is like for me when I am in a desperate and hopeless place. The assumptions you made left me feeling blamed and criticised for the fact that I am unwell.

I was particularly upset by the way you recorded our last meeting in your letter. Reading that, it is clear that you didn’t listen to me. When I have made myself vulnerable and shared such sensitive details with you, it is painful to feel unheard. It makes it very difficult for me to trust you again. I don’t think this is unreasonable.

There are some significant mistakes in the letter; for instance, saying I was sent home from A&E by a psychiatric liaison. I clearly told you several times that I had not seen a psychiatric liaison in the hospital. And our appointment was not brought forward, as you state in the letter, it was at the time scheduled weeks previously.

Aside from those mistakes, I was angry that you wrote about me in a way I found patronising. You wrote that I have to ‘take some responsibility’ over my actions. It may not be what you intended, but it sounds like you are referring to me as a child that needs to be reprimanded. Again, this feels blaming to me, and I don’t feel I should be blamedfor actions I have taken in utter desperation. I’m left feeling as though you have absolutely no understanding of how it feels to be in that desperate place. I already beat myself up every day about the way my illness makes me behave. It is incredibly unhelpful that you wanted to add more blame.

The way I feel now is not how I experienced you during the rest of the time you have been treating me. Previously, I had felt respected by you and I valued your support. I really appreciated that you made yourself available on the phone when I needed to talk to you. I am grateful for the effort you made to be of help during this time.

Unfortunately, the trust I placed in you has been damaged and I no longer feel confident that working with you will be productive for me. I have no faith that antidepressants will have a positive impact, and I am unwilling to endure the process of trial and error and all the horrible side effects that come along with attempting to find one that works.

Sincerely,

Laura

I’m planning to post this letter tomorrow and feeling nervous about it. I thought sharing it here first might help.

I think it comes across with just the right tone. It’s respectful and not too emotional but still conveys your distress and importantly, corrects the record as far as the errors in his account of events. I’m sure he’ll think you are misguided about the antidepressants because his training is to have faith in them, but there is nothing you can do about that.

Most important is that you have written at all, and are ending the doctor-patient relationship in a calm and clearly documented way. That is a million times better than just running away or sending an angry letter (yeah, both of those would be me). Well done.

Thanks for the feedback, I was worried it was a bit over-emotional. I’m sure you’re right about the antidepressants. But I will have to be OK with him disagreeing I guess. I was tempted to just run away from this situation, but I realised I would feel better about it if I explained. That is quite new for me, I usually just cut and run when a relationship goes wrong.

I like that it’s a calm and clear explanation of the reasons you want to quit working with him. You aren’t ranting. You aren’t denying all the things he has done for you. It’s very balanced, which I think greatly increases the chance that he will be able to read it and take in what you have to say.

Thanks, it is reassuring to hear that you read it that way. I don’t want to lash out at him, but I do want him to understand how what he’s said impacted me. Maybe he will then make an effort to be gentler with people in future.